What to Expect During Pelvic Floor Therapy

If you are wondering what really happens during pelvic floor physical therapy (PFPT), you are not alone. Many people are referred by their doctor, hear about it from a friend, or stumble across it while searching for answers to symptoms like leaking, pain, or pressure. It is completely normal to feel nervous or uncertain about what an appointment entails.

Pelvic floor therapy is designed to help you feel better in your body, and the process is much less intimidating than most people expect. At Origin, we believe that the more you know before your first visit, the more comfortable and confident you will feel walking through the door.

What is pelvic floor physical therapy and who can benefit?

Pelvic floor physical therapy (PFPT) focuses on the muscles that support your bladder, bowel, and reproductive organs. These muscles play a huge role in how you move, exercise, and function every day. Whether these muscles they are too tight, weak, or a combination of both, you may experience:

• Leaking with coughing, sneezing, or exercise
• Pain in the pelvic region or lower back area
• Pressure or prolapse
• Sexual dysfunction or pain with sex
• Constipation or difficulty emptying 

Everyone has a pelvic floor, meaning everyone can benefit from learning how to care for it. Pelvic floor physical therapy (PFPT) isn’t just for people who are pregnant or postpartum. Regardless of sex or gender people at all lift stages seek PFPT for both symptom relief and prevention.

Additionally, Pelvic floor therapists are trained in orthopedics and take a whole-body approach to care. As specialists in women’s and pelvic health, they understand how the body’s systems work together, and how hormones, posture, and daily habits can all influence PF function and overall well-being.

Does insurance cover pelvic floor therapy?

Often, yes! At Origin, we accept most major insurance providers, so care is both accessible and as low as $0 cost per session. More information about our insurance policies can be found here and here.

Virtual vs In-clinic pelvic floor therapy

You may be wondering whether you should book your visit in person or online. The truth is, most of what we treat at Origin can be done virtually.

Virtual Care

Virtual pelvic floor therapy is a great fit if you:

• Prefer the convenience of a virtual visit
• Want advice on how to move or do exercises in your home environment
• Do not have a clinic nearby
• Cannot easily find childcare
• Have a busy schedule that makes travel difficult
• Have a history of trauma and want more control over your environment

During a virtual visit at Origin, you meet one-on-one with a credentialed physical therapist via a secure, HIPAA-compliant Zoom meeting. Your provider will listen, assess your symptoms, and walk you through a comprehensive health history, pelvic floor self-check, and tailored exercises. When it comes to the pelvic floor self-check, you can do this on your own time and report back to us, or we ask you to turn off your camera so we can guide you through it. You always have a say in what you participate in during PT and our providers will go at your pace.

Still unsure? Read more: Is Virtual Care at Origin Right for You?

In-person care

As with virtual visits, during your in-person appointment you will meet one-on-one with a credentialed physical therapist who will listen, assess your symptoms, and walk you through a comprehensive health history, pelvic floor self-check, and tailored exercises. Unlike virtual visits, in-person appointments will involve your physical therapist providing hands-on evaluation and other treatment techniques that aid in your ability to understand how your muscles and body systems are functioning together. Many patients choose a hybrid approach, starting virtually and transitioning to in-person or combining both for ongoing support.

In-clinic physical therapy can be helpful for anyone who:

• Finds connecting to what's happening in their body challenging
• Prefers hands-on treatment

What happens during your first pelvic floor therapy appointment?

Knowing what to expect ahead of your first appointment can take away much of the mystery and hopefully alleviate any anxiety you might be feeling. The goal of the first session is to learn more about you, teach you about the pelvic floor, how it works and how PFPT can help, and establish a plan of care with actionable steps you can take right away. 

What to Bring

Wondering what to bring to your first appointment? We’ve got you covered.

Be sure to bring your insurance card, a prescription from your doctor (if you have one), and wear clothing you will feel comfortable moving in. If you’re on a virtual call, be sure you have space to move around. Lastly, make sure you've completed your intake forms ahead of your appointment.

Intake and Education

At the start of your visit, your physical therapist will ask questions about your medical history, current symptoms, lifestyle, and what you would like to achieve during PT. This is your time to share your story and relay your goals.

You will learn about how the pelvic floor works, why you may be experiencing symptoms, and how PFPT can help. Nothing is done without thorough explanation, and your PT will encourage questions throughout.

Assessment

Of course, your physical therapist will also perform a physical exam to better assess your symptoms, root cause, and develop a comprehensive plan of care. The physical exam may look different depending on your symptoms and goals, and whether your visit is virtual or in person:

External exam: 

Whether your visit is virtual or in-person, your PT will begin by observing your posture, breathing, and general movement patterns, since these can all influence how your pelvic floor muscles function. If you are in person, your provider may ask to look at your tissues while you perform actions like squeezing or relaxing your pelvic floor to understand how your muscles are coordinating. If you consent, they may gently press on the muscles externally to get a sense of tone and sensitivity.  During this part of the exam you are not in stirrups and you are draped with a sheet.  There are additional tests your provider may recommend be performed based on your history, but like any other part of an exam, it's done with informed consent.

Internal pelvic floor exam (in clinic): 

If you and your physical therapist decide an internal exam would be helpful, your PT will begin with a detailed explanation of every step so you know exactly what to expect. You’ll be comfortably positioned on the exam table with pillows supporting your legs, hips, and head (still no stirrups here!). A sheet is used to protect your privacy and is only moved when necessary.

Before an internal exam is performed, your PT will visually check the vulva and anus (the external tissues between your pubic bone and tailbone) to check for signs of scarring, irritation, or tension. To examine the pelvic floor muscles internally – with your consent of course! – your PT will gently insert one gloved, lubricated finger into the vagina or rectum to assess your pelvic floor. This allows them to feel how your muscles are working, including any strength or coordination issues. It also helps them evaluate for the presence of tenderness or trigger points, taught bands in muscle that can cause referred pain at sites away from where they are identified.

A physical exam is never required and only performed with your full, informed consent. Your PT will check in with you throughout and adjust or stop at any point to ensure you are comfortable. 

Plan of Care

Before you leave your first visit, you and your therapist will set collaborative goals and create a realistic home exercise program based on your individual lifestyle and needs. Your PT will explain what to expect during future sessions, how progress will be measured. Recommendations based on the first visit will be available for you to review in the patient dashboard. 

What ongoing pelvic floor therapy treatment can look like

Pelvic floor therapy is not one-size-fits-all. Your plan may include:

• Manual therapy to release tension
• Tailored strengthening or relaxation exercises
• Education about daily habits and lifestyle modifications
• Support for returning to exercise, sex, or other activities without symptoms
• Biofeedback to improve awareness of muscle function

Treatment evolves over time and it’s normal to continue adapting your plan alongside your therapist to ensure it aligns with your goals and current lift circumstances.

Is pelvic floor therapy worth it?

Many people ask if pelvic floor PT is embarrassing or uncomfortable. The answer is no. Nothing is TMI here! Origin clinicians often hear from our patients that they leave their first appointment feeling hopeful and empowered, and wish they had started sooner. With the right guidance, you can learn to reduce uncomfortable symptoms, gain control over your body, and feel more confident in daily life.

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Sources

“Biofeedback.” Physiopedia, editors Tim Watson, Rachael Lowe, Ellen De Boitselier et al., Physiopedia, last edited 370330 version. Web. [October 1, 2025]. https://www.physio-pedia.com/Biofeedback.

“Manual Therapy.” Physiopedia, edited by Finn Gerstell, Jess Bell, et al., Physiopedia, last edited 357394 version. Web. [October 1, 2025]. https://www.physio-pedia.com/Manual_Therapy.